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NPI Code Detail

MEDICARE: STEVEN PETRIN FNP

MEDICARE: STEVEN PETRIN FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerCNP81444ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609852086
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN PETRIN FNP
Provider Business Mailing Address
First Line : 1 MEDICAL CENTER DR
Second Line :
City : BIDDEFORD
State : ME
Zip : 04005-9422
Country : US
Telephone Number : 207-283-7000
Fax Number : 207-282-9128
Provider Business Practice Location Address
First Line : 25 JUNE ST
Second Line :
City : SANFORD
State : ME
Zip : 04073-2621
Country : US
Telephone Number : 207-490-7860
Fax Number : 207-604-7409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 04/08/2014

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